Health care - Hospital's point of view. . .

[Valkenar]

1, 3

Good info, thanks.

The other stuff relates to healthy (and lucky) people, which obviously removes any need for healthcare, and consequently, insurance.

if you aren't paying for insurance and aren't paying the EXTREMELY high taxes that happen in a government run system, then you should have enough spare change to pay for any care you need. If not, well then you're an idiot.

I'm starting to think you either are making up the stuff about how your family background is non-wealthy, or you've totally forgotten what it's like. There are lots of non-idiots who can't afford things much cheaper than medical care. I'm not sure why you talk about people being forced into bankruptcy as if it's a good way for a civilized country to operate.

You know what, Justin? You are only a few intellectual steps away from me converting you to a libertarian way of thinking.

Oh, I'm a libertarian in some things. Unfortunately I also believe in social responsibility.

Glen

Welcome to the corporate world!
And why I hope to never go back to it.

I've worked at the same company for the past 12 years. I'm not the authority here, but I'm treated with respect. But if my boss started using a need for health insurance to pressure me to work longer hours or something, I'd be out faster than you can say "take this job and shove it"

[CANDANeh]

I've seen enough comparisons in hospital quality to know that the Canadians don't have any bragging rights on the U.S. Lower utilization? Absolutely. For instance they're a lot less likely to have a surgical intervention when a patient is suffering from narrowed coronary arteries. The death rate isn't any different, but that angina sure can suk. You trade one poison (high cost) for another (high pain).

"Free" health care? Are you sheeting me?

Actually I was being sarcastic My last employer at times sent injured workers south of our border as waiting for interventions here put workers compensation cost through the roof. And this article speaks loud and clear.http://www.cbc.ca/canada/newfoundland-l ... t-201.html
So much for "free" lucky he can pay EH

[Glenn]

Oh, I'm a libertarian in some things. Unfortunately I also believe in social responsibility.

That's what always gets me too, I just can't be an economic determinist like Bill, no matter how hard I try!

I've worked at the same company for the past 12 years. I'm not the authority here, but I'm treated with respect. But if my boss started using a need for health insurance to pressure me to work longer hours or something, I'd be out faster than you can say "take this job and shove it"

I was in the corporate world for 13 years before it finally tossed me out. For the first 7 or so years it was great because we were a thriving local company of around 1000 employees, and little bothered by the global parent corporation. There was lots of opportunities, as well as respect in both directions, during that time. When I moved up into the IT division in 1999 we were local teams all under one local VP (a 20+ year career employee who had helped build the company to its then current level of success) supporting the local company...it was like a family, and I enjoyed going to work.

Then around 6 years ago the parent corp decided to take a more active role and integrate us into the collective. It started with a divide-and-conquer strategy of firing local VPs and restructuring their employees under VPs located elsewhere within the parent corp. I walked in one day to find that our local IT VP had been sacked and the teams under him were divided up among about 5 VPs in Chicago.

Overnight work became a completely different place. The local company essential ceased to exist except as a brand name. The opportunities also dried up because the next step in their strategy was to make sure that most higher positions here were either sent elsewhere or people from elsewhere (usually Chicago) were sent here to fill them. Three of my last four managers were in Chicago. I reported to the last manager I had for about a year and never met him, he never seemed to make it from Chicago to Lincoln to meet us. I didn't hear anything from him for a couple days after I was notified that I was being laid off (by some VP who came down from Chicago to give that news to those affected), and when I did finally hear from him it was just a quick call to tell me who I needed to transfer my responsibilites to. Yeah, it was a way different place from when I started.

Yet throughout those last six or so years I wasn't about to leave on my own, I wasn't letting them off that easy. I went in each day and did my job, and did it well...and during that time I also worked at getting my finances back in order after a disasterous couple of years of one medical issue after another nearly drove us to bankruptcy, as well as eventually going back to graduate school part time. I bided my time until the current round of layoffs relieved my suffering and I got the long-awaited severence package. And I'm definitely glad to be rid of what that place has become.

[Glenn]

I shouldn't be so hard on indentured servitude as to compare it to the corporate world. My most distant direct ancestor that we have been able to trace was a Thomas Humphries who came over to the Virginia colony in the 1640s as an indentured servant, likely seeking to escape the English Civil War as were many others who came over during that decade. We were Virginians until the late 1700s when one of my ancestors migrated to Kentucky (which had originally been part of the Virginia colony). At any rate, without indentured servitude I likely wouldn't be here!

[Bill Glasheen]

I'm starting to think you either are making up the stuff about how your family background is non-wealthy, or you've totally forgotten what it's like.

Oh really???

We almost never went out to eat, Justin. A third of my suppers were left-overs. I NEVER had new clothes; all mine were hand-me-downs.

My father paid for his own education with odd jobs. (BS in civil engineering at Manhattan). He moved with mom to Virginia to work for NACA (now Langley NASA). He built his own (brick) house from the construction company he started (from scratch) and ultimately sold (before becoming a broker).

I remember this car. It was really cool.



My dad drove that thing for over 200,000 miles - something extraordinary at the time. I remember the hospital puke green paint job he did on the body to make it stop rusting out.

This was the next POS my dad drove after kids 7 and 8 came.



They don't make Ramblers any more. American Motors got bought up by a French auto company (oxymoron if there ever was one).

My dad is comparatively wealthy now because: 1) he grew up in the depression, and 2) he understood and lived the concept of delayed gratification. We wasted NOTHING at home. Never bought a baggie, because we used plastic bags from bread. Repeatedly. Never had a clothes dryer. Etc., etc. And yet... he invested in the market. He took a very little bit of savings and built something incredible. He knew how to take BIG calculated risks, and had the drive to see it through. And mom (valedictorian of her high school class) became his business partner.

Yea, Justin, we were poor. But cream rises. I wish I could be as successful as my (still living) dad was.

Oh, I'm a libertarian in some things. Unfortunately I also believe in social responsibility.

What does social responsibility have to do with big government? The two are mutually exclusive.

Sorry I missed you on your Honeymoon. If you're ever in Virginia again, I'd like to give you a tour of the dozen bronze statues (and counting) that my dad helped design and hired an artist to build for many of the churches in the Tidewater area. Nobody told him how to be socially responsible. He took the memory of my mom, built a charitable foundation in her name, and now cannot give from it fast enough.

Government could never do that. Government gets in the way, telling him how much he must spend from these charitable trusts. They frown on them doing well. Some social responsibility...

I've worked at the same company for the past 12 years. I'm not the authority here, but I'm treated with respect. But if my boss started using a need for health insurance to pressure me to work longer hours or something, I'd be out faster than you can say "take this job and shove it"

Here's the thing, Justin. Do you know what entity gives the richest health insurance benefits? State and federal government. I saw the data. I did a research study that surveyed 15,000 members of the state government plan and the local utility plan. Even the benefits manager from the state says the only reason people work for state government is the benefits.

Big bad corporation? I don't think so. State workers stay ONLY because of their benefits. The pay otherwise suks. So the state benefits manager told me. And with every national BCBS meeting I went to, my counterparts in other BCBS plans told me that the state workers were the same where they were.

Maybe a paradigm shift is in order.

- Bill

[Valkenar]

Oh really???

Well no. I didn't actually think you were making it up... but when you call people idiots for not having enough money I kind of wonder what planet you're on. I respect your story, but why is it that everyone who sees a rags to riches story assumes that can be the norm and that anyone who doesn't do the same must just be stupid?

Cream rises. Unfortunately socioeconomics is not as simple as that.

What does social responsibility have to do with big government? The two are mutually exclusive.

Ah, sweet, sweet hyperbole. For example...

Here's the thing, Justin. Do you know what entity gives the richest health insurance benefits? State and federal government.

Without knowing the details I would guess that this is caused by the fact that most people will get pissed if they see competitive salaries being paid to government employees, but don't get so pissed about low salaries and high benefits. But this is all sort of beside the point. You seemed to be implying (and correct me if I'm wrong) that one nice thing about people being ruined if they lose their health insurance is that they become good, loyal workers because they're so desperate to keep their jobs. That to me isn't exactly socially responsible behavior on their employer's part.

[IJ]

"I know my world, Ian. Trust me - that kind of conversation never happens. That scene was high on the cinematic license. You know... Confronting the CEO in a restaurant who happened to be dining on a thick steak. All metaphors apply."

Yup, like I said, distorted to similar degree as the rest of the show and most shows like it.

"I hear now and then that a doctor will drive a fancy car. The only doctor I ever knew who did health care for free was an MD who worked in my research unit. She spent one day a week volunteering her services in a free clinic. She's now the Virginia State Health Commissioner. These are rare birds."

I am missing the point here. The CEO's don't? Or... what?

"You either aren't a good judge of character and/or you don't follow the show. His "sociopathic" behavior is a device he cavalierly uses to achieve an end. He also has personality "issues" - as do all of us. (You have an edge to your personality as well, Ian. It's partly why I like you. Wink) Interestingly enough, he tries to hide his softer side so he can keep both his enemies and his direct reports on their toes."

Um, I've seen enough of the show to know that his behavior would be considered unacceptable across the board. It's also unnecessary. He needs to pretend to be a sociopath (only the viewers can tell its fake, not any of the people who spend their lives with him) to control his enemies and his direct reports? Jesus H. Real hospitals don't have complicated enemy networks or require underlings to be in fear. People work better when not in fear. Bad behavior would play into the hands of enemies. You catch more flies with honey--but fewer viewers. As for my edge, it doesn't come out with patients and trainees--the religion discussion was a good example. Patients would never hear my opinions on their religion in a million years, only offers to help.

"High on testosterone? You bet. I've seen MUCH more such bad-boy behavior in surgery. Like fighter pilots, it's part of the breed. It's why you don't find females flocking to that specialty."

They're a bunch of penises, and that's good because??? There is no need whatsoever to be a jerky surgeon; you can be an extremely competent, daring, cutting edge nice person surgeon, and I've met them. I've also met awful people who got away with too much because they were valuable for their skills and research dollars. That tolerance is waning, however. Emphasis on surgical cooperation, checklists, and polite behavior and team attitudes are reforming the OR.

"He was addicted to oxycontin because of his constant leg pain. The addictive personality would come up in the plot line. ... Never happens, you say? Guess again. We kicked such doctors out of the network all the time when said behavior affected patient care."

He also stole some stimulants off a patient--witnessed by his team. I saw that one. Being on oxycontin is one thing, dependent another--but if he were addicted, he'd be in some kind of monitoring and treatment or he'd lose his iicense. Rather than me saying it never happens, this is me saying it gets dealt with very seriously if it comes to anyone's attention (and House would). I can't stand the show--but fill me in--is the well-being committee following him and randomly testing his urine several times a month?

[Bill Glasheen]

You seemed to be implying (and correct me if I'm wrong) that one nice thing about people being ruined if they lose their health insurance is that they become good, loyal workers because they're so desperate to keep their jobs. That to me isn't exactly socially responsible behavior on their employer's part.

This logic completely escapes me.

Given the lives of the working poor I know who have no insurance and are very sick, I fail to see how providing a needed benefit in exchange for loyalty is socially irresponsible. I highly recommend you read the book The Seven Habits of Highly Successful People. In particular, read up on Habit 4 (Think Win/Win: Principles of Mutual Benefit).

- Bill